Jeong Suk Kim, D.D.S., INC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53713 Issued in CA

Practice address

408 W 4TH St
Santa Ana, CA 92701-4505

Phone

(714) 836-9999

Fax

(714) 836-8496

NPI assigned

Aug 9, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Sue Kim Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1396936795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W 4TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014505",
            "telephone_number": "714-836-9999",
            "fax_number": "714-836-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W 4TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014505",
            "telephone_number": "714-836-9999",
            "fax_number": "714-836-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONG SUK",
        "name_prefix": "Dr.",
        "credential": "D.D.S., INC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUE",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hyung Oh Kim Sr., MD
• Hyunjoo Kim
• James Anthony Kim, M.D.
• Janet Kim, OTR/L
• Jason Kim, DO
• Jessica Kim
• Ji Yeon Kim
• Jin Hwan Kim
• Joseph Kim, M.D.
• Joseph K Kim, D.D.S.

• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.